The proposed ADM Scientist Development Award (K21) outlines a five-year program of training and research in substance abuse with a focus on treatment development for HIV-positive intravenous drug abusers. The candidate is a health psychologist and junior faculty member at Yale University, whose primary preceptor is Bruce Rounsaville, M.D., an established researcher with an outstanding record of mentoring research scientists. Other preceptors include Kathleen Carroll, Ph.D., Edward Kaplan, Ph.D., Thomas Kosten, M.D., Richard Schottenfeld, M.D., and Peter Selwyn, M.D., all established investigators in the field of substance abuse and AIDS. The research plan has three parts: (a) an assessment study examining methadone patients' high-risk attitudes and behaviors from a Health Belief Model perspective; (b) a retrospective matching study in which the differential efficacy of standard Coping Skills Training, alone or in combination with pharmacologic and non- pharmacologic treatments, will be investigated for reducing high risk behaviors in methadone patients, using HIV status as a matching variable; and (c) a Stage I behavioral therapies project, in response to PA-94-078, in which Risk Reduction Therapy (RRT) will be developed and evaluated. RRT is a modified coping skills training approach to HIV risk reduction adapted to meet the special needs of HIV-positive drug abusers through inclusion of cognitive remediation strategies and attention to the medical and emotional needs of this patient population. The career development plan includes formal course work and mentoring in psychotherapy development and process research, biostatistics, chronic disease and HIV/AIDS epidemiology, and neuropharmacology.
